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ACP Steps Up Efforts to Prevent Demise of the Affordable Care Act

Texas judge's ruling to overturn the law would affect nearly every American, ACP warns

Jan. 11, 2019 (ACP) – The decision by a federal judge in Texas intended to overturn the Affordable Care Act has amped up efforts by the American College of Physicians and its allies who want to protect health coverage for tens of millions of Americans.

“This case represents yet another attempt to kill a law that has benefited millions of Americans,” said Ryan Crowley, senior associate for health policy with ACP. “The law has its flaws, and they need to be addressed. But, millions of people now have coverage because of the ACA, and the nation's health care system is better off with the law than without it.”

In December 2018, U.S. District Court Judge Reed O’Connor ruled that the ACA is unconstitutional. The ruling was in response to a lawsuit filed by several Republican-leaning states.

“He sided with the plaintiffs, who are mostly Republican attorneys general, and ruled that the ACA's individual mandate is unconstitutional because Congress eliminated the financial penalty for not having coverage,” Crowley explained. “He also concluded that the law would essentially collapse without the mandate, and therefore the rest of the ACA would have to be struck down.”

For now, however, the ACA remains in place. The judge has stayed his ruling – put it on hold – during the appeal process because “many everyday Americans would otherwise face great uncertainty,” he wrote in a court filing.

Democratic-leaning states and Democratic members of Congress are expected to appeal the judge's ruling to the next higher court, the Fifth Circuit Court of Appeals.

“Many experts expect that appellate court to disagree with O’Connor's ruling that the individual mandate can't be separated from the rest of the law,” USA Today reported. “If O’Connor's ruling is upheld, it is expected that the case would head to the Supreme Court.”

If the ACA is ultimately extinguished, Crowley warned, “millions will lose Medicaid coverage, pre-existing condition protections will be eliminated, and costs of uncompensated care will rise.”

In addition, he said, other protections provided by the ACA will disappear, including preventive services at no extra cost and prohibitions on annual and lifetime dollar limits. Also, he said, some seniors who receive their prescription drugs through Medicare may have to pay higher prices, and dependent children won't be able to stay on their parents' insurance plans until age 26.

“It's safe to say nearly every American will be affected in some way if this decision stands,” Crowley said.

Before the ruling, ACP had joined the American Medical Association and other groups in filing a friend-of-the-court brief that outlined how eliminating the ACA would wreak havoc on the health care system. After the ruling, Crowley said, “we issued a statement calling for the ruling to be overturned and joined other frontline physician groups to call for the decision to be reversed on appeal.”

Yale law professor Abbe Gluck told USA Today that the appeals court isn't likely to issue a ruling until June at the earliest. If the appeals court overturns the ruling and allows the ACA to continue to exist, Gluck said, the Supreme Court may decide not to hear the case. According to her, it's “extremely weak on the law, and I don't think anyone on the court has the appetite for another politicized Obamacare showdown.”

But, if the appeals court upholds the judge's ruling, she said that the Supreme Court may consider the case in the fall.

At the congressional level, Democrats who now control the House of Representatives are working to intervene in the case. A vote scheduled for early in the current session, according to a Washington Post report, is “designed to force GOP lawmakers into a political corner: agree to defend a law many members have spent years reviling or appear to oppose popular ACA protections for millions of Americans with pre-existing medical conditions that many have pledged to uphold.”

ACP is closely monitoring the wrangling in the courts and Congress, and “we will continue to do what we can to protect the law, given what could happen if it's eliminated,” Crowley said.

More Information

ACP issued a statement objecting to the Texas judge's ruling. The College also signed on to a joint statement with other health care groups urging an appeal and reversal of the ruling. Both can be viewed on the ACP website.